ArticleThe International journal on drug policy2021
Modeling the role of incarceration in HCV transmission and prevention amongst people who inject drugs in rural Kentucky.
Article in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- The global epidemiology of injecting drug use, HIV, viral hepatitis and tuberculosis among people who are incarcerated: a multistage systematic review.The International journal on drug policy · 2026Pooled it
- Article
- Trends in hepatitis C care in Canada's provincial and territorial prisons from 2020 to 2024.Canadian liver journal · 2025Article
- Evaluating public health vending machine rollout and utilization in criminal-legal settings.Journal of substance use and addiction treatment · 2025Article
- Article
- Unmet need for medication for opioid use disorder among persons who inject drugs in 23 U.S. cities.Drug and alcohol dependence · 2024Article
- Article
- Enduring Injustice: Infectious Disease Outbreaks in Carceral Settings.The Journal of infectious diseases · 2024Article
- A Prospective Study of Injection Drug Use and Jail Readmission in Two Western North Carolina Counties.North Carolina medical journal · 2023Article
- Prison-based interventions are key to achieving HCV elimination among people who inject drugs in New South Wales, Australia: A modelling study.Liver international : official journal of the International Association for the Study of the Liver · 2023Article
- How the rural risk environment underpins hepatitis C risk: Qualitative findings from rural southern Illinois, United States.The International journal on drug policy · 2023Article
- Dynamics of Respiratory Infectious Diseases in Incarcerated and Free-Living Populations: A Simulation Modeling Study.Medical decision making : an international journal of the Society for Medical Decision Making · 2023Article
- Modeling the population-level impact of opioid agonist treatment on mortality among people accessing treatment between 2001 and 2020 in New South Wales, Australia.Addiction (Abingdon, England) · 2022Article
- Dismantling War on Drugs Policies in COVID-19's Aftermath.American journal of public health · 2022Article
- The contribution of unstable housing to HIV and hepatitis C virus transmission among people who inject drugs globally, regionally, and at country level: a modelling study.The Lancet. Public health · 2022Article
- Modelling the intervention effect of opioid agonist treatment on multiple mortality outcomes in people who inject drugs: a three-setting analysis.The lancet. Psychiatry · 2021Article
- Modeling as Visioning: Exploring the Impact of Criminal Justice Reform on Health of Populations with Substance Use Disorders.MDM policy & practiceArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundPeople who inject drugs (PWID) experience high incarceration rates, with current/recent incarceration being associated with increased hepatitis C virus (HCV) transmission. We assess the contribution of incarceration to HCV transmission amongst PWID in Perry County (PC), Kentucky, USA, and the impact of scaling-up community and in-prison opioid substitution therapy (OST), including the potential for reducing incarceration.
methodsA dynamic model of incarceration and HCV transmission amongst PWID was calibrated in a Bayesian framework to epidemiological and incarceration data from PC, incorporating an empirically estimated 2.8-fold (95%CI: 1.36-5.77) elevated HCV acquisition risk amongst currently incarcerated or recently released (<6 months) PWID compared to other PWID. We projected the percentage of new HCV infections that would be prevented among PWID over 2020-2030 if incarceration no longer elevated HCV transmission risk, if needle and syringe programmes (NSP) and OST are scaled-up, and/or if drug use was decriminalized (incarceration/reincarceration rates are halved) with 50% of PWID that would have been imprisoned being diverted onto OST. We assume OST reduces reincarceration by 10-42%.
resultsOver 2020-2030, removing the effect of incarceration on HCV transmission could prevent 42.7% (95% credibility interval: 15.0-67.4%) of new HCV infections amongst PWID. Conversely, scaling-up community OST and NSP to 50% coverage could prevent 28.5% (20.0-37.4%) of new infections, with this increasing to 32.7% (24.5-41.2%) if PWID are retained on OST upon incarceration, 36.4% (27.7-44.9%) if PWID initiate OST in prison, and 45.3% (35.9-54.1%) if PWID are retained on OST upon release. decriminalization (with diversion to OST) could further increase this impact, preventing 56.8% (45.3-64.5%) of new infections. The impact of these OST interventions decreases by 2.1-28.6% if OST does not reduce incarceration.
conclusionIncarceration is likely to be an important contributor to HCV transmission amongst PWID in PC. Prison-based OST could be an important intervention for reducing this risk.
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